Effects of cold and hot temperature on dehydration: a mechanism of cardiovascular burden.

The association between temperature (cold or heat) and cardiovascular mortality has been well documented. However, few studies have investigated the underlying mechanism of the cold or heat effect. The main goal of this study was to examine the effect of temperature on dehydration markers and to explain the pathophysiological disturbances caused by changes of temperature. We investigated the relationship between outdoor temperature and dehydration markers (blood urea nitrogen (BUN)/creatinine ratio, urine specific gravity, plasma tonicity and haematocrit) in 43,549 adults from Seoul, South Korea, during 1995-2008. We used piece-wise linear regression to find the flexion point of apparent temperature and estimate the effects below or above the apparent temperature. Levels of dehydration markers decreased linearly with an increase in the apparent temperature until a point between 22 and 27 °C, which was regarded as the flexion point of apparent temperature, and then increased with apparent temperature. Because the associations between temperature and cardiovascular mortality are known to be U-shaped, our findings suggest that temperature-related changes in hydration status underlie the increased cardiovascular mortality and morbidity during high- or low-temperature conditions.